Abstract
We report herein on a case of bowel necrosis resulting from the administration of leuprolide acetate depot (LH-RH analog). The patient was an 82-year-old man who had undergone a prostatectomy for prostate cancer and had been taking a course of leuprolide acetate depot for ten years. The patient was admitted with sudden abdominal pain and vomiting. Small bowel necrosis was noted on contrast enhanced CT scan. The patient underwent an emergency laparotomy. Small bowel necrosis caused by mesenteric venous thrombosis was found. The necrotized intestine was resected, followed by end-to-end anastomosis. After the operation, we started anticoagulation therapy. The patient recovered well and was discharged on POD 28. Histopathological examination showed multiple thromboses in the mesenteric blood vessels. Coagulation studies showed no abnormality, so we considered that the euprolide acetate depot had induced this condition. There are some reports that this medicine has some influences on coagulatory and fibrinolytic activities. We should therefore always be on the alert for mesenteric venous thrombosis in patients on this medicine.
